title: Efficacy of high-dose methylprednisolone in patients with Crimean-Congo haemorrhagic fever and severe thrombocytopenia.
abstract: Crimean-Congo haemorrhagic fever (CCHF) is an acute viral haemorrhagic disease that is now endemic in south eastern Iran. The most important factor associated with mortality is a platelet count of less than 50,000/mL. The purpose of this study is to compare treated cases with severe thrombocytopenia using ribavirin with high-dose methylprednisolone (HDMP) with patients receiving ribavirin without HDMP. A clinical trial was conducted for confirmed patients with CCHF and severe thrombocytopenia (platelet count less than 50,000/mL) admitted to Boo-Ali Hospital in Zahedan between January 2010 and October 2011. The intervention group was given oral ribavirin, supportive managements and HDMP and the controls were treated with ribavirin and supportive management. Following HDMP therapy in hospitalized patients with severe thrombocytopenia, the platelet count increased within 36 h and the leukocyte count within 48 h of the beginning of treatment. Fewer in the intervention group required a transfusion of blood products than in the controls (P < 0.001). No one in the intervention group died. It seems that high-dose methylprednisolone is effective in the treatment of patients with CCHF. The increased platelet count and reduction of blood product requirement for severe CCHF patients after receiving HDMP are promising results. Further investigation is necessary in order to determine the efficacy of corticosteroid and its effect on outcome.
authors.affiliation: Infectious Diseases & Tropical Medicine Research Center, Zahedan University of Medical Sciences, Boo-Ali Hospital, Zahedan, Iran.
authors.forename: Batool
authors.initials: B
authors.lastname: Sharifi-Mood
authors.forename: Roya
authors.initials: R
authors.lastname: Alavi-Naini
authors.forename: Maliheh
authors.initials: M
authors.lastname: Metanat
authors.forename: Mehdi
authors.initials: M
authors.lastname: Mohammadi
authors.forename: Asad
authors.initials: A
authors.lastname: Shakeri
authors.forename: Ali
authors.initials: A
authors.lastname: Amjadi
mesh_terms: D000284:Administration, Oral; D000328:Adult; D000368:Aged; D000998:Antiviral Agents / Q000008:administration & dosage; D004359:Drug Therapy, Combination; D005260:Female; D005938:Glucocorticoids / Q000008:administration & dosage*; D006479:Hemorrhagic Fever, Crimean / Q000188:drug therapy*; D006801:Humans; D008297:Male; D008775:Methylprednisolone / Q000008:administration & dosage*; D008875:Middle Aged; D012254:Ribavirin / Q000008:administration & dosage; D013921:Thrombocytopenia / Q000188:drug therapy*; D055815:Young Adult
chemical_list: D000998:Antiviral Agents; D005938:Glucocorticoids; D012254:Ribavirin; D008775:Methylprednisolone
keywords: CCHF; Crimean-Congo haemorrhagic fever; methyl prednisolone; prednisolone; ribavirin; thrombocytopenia